Director of Quality Utilization Review & Performance Improvement

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

• The Director of Quality Assurance/UR/PI is responsible for strategic leadership and oversight of all quality-related programs and initiatives across the facility, including Utilization Review (UR), Performance Improvement (PI), Accreditation and Clinical Outcomes. This position collaborates with hospital leadership, medical staff, department managers, and external agencies to promote high-quality, cost-effective, and patient-centered care. The Director interprets clinical data, ensures compliance with applicable regulatory and accreditation standards, leads efforts to optimize resource utilization, and drives continuous performance improvement throughout the hospital.

Essential Functions

• Lead the development, execution, and evaluation of quality, UR, and PI programs aligned with organizational goals and regulatory requirements
• Oversee utilization review processes to ensure efficient and medically necessary use of healthcare resources
• Develop, implement, and monitor hospital-wide performance improvement initiatives using evidence-based practices
• Direct internal and external audits, survey readiness, and corrective action planning
• Analyze clinical and administrative data to identify trends, outcomes, and opportunities for improvement
• Lead or co-lead relevant hospital committees including Quality Council, UR Committee, and PI teams
• Act as the subject matter expert on quality, UR, and PI topics for hospital leadership, staff, and the Board of Trustees
• Facilitate complaint management and service recovery processes
• Manage departmental operations including staffing, budget, and strategic planning
• Ensure timely and accurate reporting of quality metrics and regulatory compliance data

Knowledge/Skills/Abilities/Expectations

• Expert knowledge of hospital accreditation standards, quality methodologies, and clinical performance metrics
• Proficient in data analytics, statistical methods, and quality improvement tools (e.g., PDSA, Lean, Six Sigma)
• Effective leadership, communication, and interpersonal skills
• Strong organizational skills and ability to manage multiple projects simultaneously
• Systems thinking with the ability to lead change across departments

Education

• High school diploma or equivalent required
• Bachelor’s degree in nursing or a health-related field required
• Master’s degree in a health-related field preferred

Licenses/Certifications

• Current Registered Nurse license required
• Must meet licensure requirements within time frame required by facility policy
• Basic Life Support (BLS) required
• Advanced Cardiac Life Support (ACLS) preferred
• Certified Professional in Healthcare Quality (CPHQ) preferred
• Certification in specialty area of practice highly recommended

Experience

• Minimum of five years of healthcare experience, including at least three years in progressive leadership roles
• Experience in quality management, utilization review, performance improvement, infection prevention, risk management, or accreditation required
• Demonstrated success leading hospital or system-level accreditation and performance improvement initiatives strongly preferred